Chest Pain in Children Rarely Has Cardiac Cause

Cause is usually unknown, musculoskeletal; less often pulmonary, gastrointestinal, anxiety, drugs

MONDAY, Oct. 10 (HealthDay News) -- Although chest pain (CP) is a common complaint among children, it rarely has a cardiac cause, according to a study published online Oct. 10 in Pediatrics.

Susan F. Saleeb, M.D., from Harvard University in Boston, and colleagues investigated the incidence of sudden cardiac death among 3,700 pediatric patients (average age, 13.4 years) evaluated for CP from 2000 through 2009 and discharged with a diagnosis of noncardiac CP. Patient records were assessed for demographic features, clinical characteristics, resource utilization, and presumed diagnosis. Vital status and cause of death were determined through National Death and Social Security Death Indices. The participants were followed up for an average of 4.4 years, for a total of 17,886 patient-years of follow-up data.

The investigators found that 1,222 patients had CP with exertion, of which 15 had associated syncope. The cause of CP was cardiac in 37 patients; for the remaining patients, the cause was unknown (1,928), musculoskeletal (1,345), pulmonary (242), gastrointestinal (108), anxiety-related (34), or drug-related (four). CP-related emergency department visits and cardiology follow-up visits were reported for 18 and 7 percent of patients, respectively. Death was reported in three cases, including two suicides and one spontaneous retroperitoneal hemorrhage.

"CP in children is a common complaint and rarely has a cardiac cause. Review of one decade of cardiology visits (nearly 18,000 patient years) revealed that no patient discharged from the clinic died as a result of a cardiac condition," the authors write.

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